American medical researchers have successfully used hypnosis as a diagnostic tool for investigating epilepsy in children.

Doctors at the Lucile Packard Childrenís Hospital at Stanford in California had a problem when treating children showing the symptoms of epilepsy, such as uncontrollable seizures and foaming at the mouth.

Lucile Packard Childrenís Hospital, Stanford, California

They needed to know whether suspicions of epilepsy were correct by monitoring brain activity during a seizure; for if wrong they would be unnecessarily committing young patients to lifetimes of anti-seizure medication.

For many children who appear to be suffering from epileptic seizures are actually having involuntary physical reactions to psychological stress in their lives, requiring very different treatment to that needed for true epileptic seizures.

The only way to pinpoint the true cause of an attack was to monitor brain activity during an event.

However the doctors had the problem of ensuring such a patient was wired up to the monitoring equipment at the very time when an attack occurred.

Connecting a panel of electrodes to a childís scalp is relatively easy and painless Ö but conducting a ìseizure watchî of indefinite length is far trickier.

But the problem was overcome through the clinical use of hypnosis. Child psychiatrist Richard Shaw explained: ìChildren are highly suggestible and they have great imaginations.

ìWeíve found that if we suggest they are going to have one of their events while they are in a hypnotic trance, they will usually have one.î

Which meant that instead of trying to prevent a seizure the Lucile Packard team set out to bring one about in order to discover which parts of the brain were causing the incidents ñ and then be able to treat their patients effectively.

Dr Richard Shaw

Packard Childrenís chief of paediatric neurology Donald Olson said: ìItís very difficult for parents to spend three or four days in the hospital hoping their child has a seizure. It puts them in a very uncomfortable place emotionally.î

In addition some children, simply by being in hospital, are removed from the very stressors which may cause the events, and so do not have a seizure.

Dr Donald Olson

The physicians needed to know whether these were true epileptic events, which are best treated by medication, or non-epileptic events caused by psychological stress or other neurological problems.

Both Dr Shaw and Dr Olson found hypnosis could significantly speed-up the diagnostic process. Together with former medical student Neva Howard, they tested nine children aged between eight and 16 whose seizure like events included twitching, loss of consciousness, shaking, jerking and falling.

Their results were published online in January 2008 in Epilepsy & Behavior and the clinicians say that although hypnosis may not work for every child, the technique is an important tool, which can speed proper diagnosis and treatment for children suffering from seizure like events.

To hypnotise the subjects, Dr Shaw, an associate professor of psychiatry and behavioural sciences and of paediatrics at the Stanford School of Medicine, first used a combination of deep breathing and progressive muscle relaxation to induce a state of relaxation and deep focused attention in the subjects.

He then used a combination of imagery and suggestion to induce one of their typical seizure like events.

Children typically visualise being at one of their favourite places ó for one teen, it was on a beach in the Bahamas.

After a hypnotic trance was established, Dr Shaw would then direct the child to recall the feelings or events that usually precede a typical seizure. Electrodes on the childís scalp recorded their brain activity during the session.

In eight out of nine cases, Dr Shaw was able to successfully trigger a seizure like event with this procedure. After an appropriate monitoring interval, he then directed the hypnotised child to ìreturnî to his or her favourite place and the episode would stop.

Using this technique, the physicians found that all eight of the subjects were experiencing non-epileptic events.

Dr Olson added: ìWe had a number of clues that these particular children might not have epilepsy but hypnosis helped us confirm our suspicions.î Physicians begin to suspect causes other than epilepsy if an individual has a variety of episodes, if the personís cognition is unaffected despite frequent seizures or if the person has a pre-existing psychiatric diagnosis.

Dr Shaw often couples psychotherapy with self-hypnosis lessons to teach children how to avoid the events.

ìWhen theyíre feeling out of control, this is a tool they can use. They know that they were able to ëturn offí an event during the initial hypnosis, and that gives them confidence to try it themselves,î he said.